| Atherosclerosis (As) poses a serious threat to human’s health and incurs a high incidence rate in the West led by the US and European countries. According to a WHO report, As-caused cardiovascular and cerebrovascular diseases generate the world’s highest incidence and death rates. Driven by rapid socioeconomic development, these diseases have become a leading contributor to death in China. As can be triggered by a wide variety of factors and its incidence and death rates grow annually in China. This is largely attributable to changes in Chinese diet and social and mental states, and the faster pace of life, coupled with other factors such as genes, environment and metabolism.Traditional Chinese medicine (TCM) does not discuss As symptoms or types, but similar symptoms are described in chest impediment, true heart pain, turbid phlegm, dizziness, and stroke in TCM records. Notably, chest impediment and true heart pain register characteristics similar to those of the As-caused heart disease. Turbid phlegm, dizziness, and stroke, etc show signs similar to those of As-induced cerebrovascular and peripheral arterial diseases. Other symptoms are also documented in As-related records. The disease involves complex etiologies and pathogenesis. TCM attributes the disease primarily to aging and weakness, improper diet, emotional disorder, and fatigue and internal damage. According to TCM, this disease is caused by deficiency in origin and excess in superficiality, deficiency-excess mixing, and in most cases harms zangfu organs such as heart, liver, spleen, and kidney. Deficiency in origin reflects the deficiency in any of these four organs. Excess in superficiality describes pathologic factors such as turbid phlegm, water-rheum, and blood stasis. Modern medicine relies mostly on statin drugs to treat As. These drugs reduce blood lipid, improve the dilatation of blood vessel endothelium, and also provide resistance against inflammation and oxidization. However, statin drugs produce side effects like other Western medicines. This stimulates research on As treatment using traditional Chinese medicine, which is unrivalled in the world of modern medicine. The concept of holism and treatment based on syndrome differentiation can suppress the As process through a number of procedures and targets to prevent and treat As.Underpinned by his long-term study on the treatment of cardiovascular and cerebrovascular diseases, Professor Luo Luyi has built unique insights about As prevention and treatment. By incorporating the perceptions and treatments of medical experts throughout history regarding the etiological factors and pathogenesis of such diseases into his years of clinical experience, he has developed a series of mature academic thoughts on such diseases. As the cornerstone of these thoughts, he describes the pathogenesis of As as kidney deficiency coupled with turbid phlegm and blood stasis and proposes the methods of tonifying kidney, activating blood and resolving phlegm for treating the disease. Based on these guiding principles, he has developed a number of highly effective prescriptions for clinical use. Based on the blood-activating and phlegm-resolving formula, Professor Luo has developed for treating the coronary heart disease, and this research aims to explore the oxidative stress effect of As. Based on changes in patients’blood lipid, superoxide dismutase (SOD), malonic dialdehyde (MDA), and oxidation low lipoprotein (ox-LDL) before and after the treatment, and the results of neck vascular ultrasound examination, the paper attempts to determine that traditional Chinese medicine can subdue the As process through anti-oxidation. By exploring how TCM prevents and treats As through anti-oxidation and assessing the efficacy and safety of the TCM treatment, this research will contribute significantly to the effort to explore the benefits of TCM in As prevention and treatment.Clinical studyPurpose: Verify that the formula has antioxidant effect on As based on the observation of changes in patients’blood lipid, SOD, MDA and ox-LDL and the results of neck vascular ultrasound examination and an objective assessment of clinical symptoms and efficacy before and after the treatment using the blood-activating and phlegm-resolving formula.Method:Select150As patients from our department, including83men and67women. Divide the patients randomly into three groups, including one treated with blood-activating and phlegm-resolving formula (blood-activating and phlegm-resolving formula Group, BAPR), one with statin drugs (western medicine statin Group, WMS) and one under combination therapy(combination therapy Group, CTG). These groups are respectively administered the blood-activating and phlegm-resolving formula, Rosuvastatin calcium and a combination of Chinese and Western oral drugs over a period of24weeks. At the end of the observation period, use a biochemical analyzer to detect changes in patients’ blood lipid and lipoprotein and the methods of pyrogallol auto-oxidation, TBA and ELISA to examine SOD, MDA and ox-LDL respectively before and after the treatment. Through neck vascular ultrasound examination, measure intima-medic thickness in the carotid artery, check the artery for plaques and determine the nature and types of the detected plaques. Compare the results statistically using the SPSS21.0software. Conduct a chi-square test on quantitative data and T-test and analysis of variance on qualitative data. Perform paired-samples T-test for intra-group comparison and independent-samples T-test for inter-group comparison before and after treatment. All the numeric values are expressed as M±SD (X±S).Result:1) The results of blood lipid and lipoprotein tests revealed that TC, TG and LDL-C levels are lowered while HDL-C levels are elevated considerably for all the three patient groups, and these results are statistically significant (P<0.05or P<0.01). Inter-group comparison showed that better As curative effects are observed for the combination therapy group than for the other two groups-the group treated with the blood-activating and phlegm-resolving formula and the group administered statin drugs (P<0.01).2) The SOD, MDA and ox-LDL tests revealed that SOD are significantly increased, ox-LDL and MDA levels are significantly reduced for all the three patient groups (P<0.05or P<0.01). The TCM treatment group and the group under treatment with a combination of Chinese and Western medicine showed a significantly higher level of antioxidant factor SOD (P<0.01). The inter-group comparison indicated that the combination therapy group showed significantly better curative effects than the other two groups in terms of reducing ox-LDL and MDA levels (P<0.01). In terms of increasing SOD, treatment for the combination therapy group is as equally effective as that for the TCM treatment group (P>0.05).3) The results of neck vascular ultrasound examinations on the three groups of patients revealed that intima-medic thickness in the carotid artery is variably reduced (P<0.05) and the number of plaques also lowered (P<0.01) for all the three treatment groups. The combination therapy group showed better curative effects than the other two groups in terms of reducing intima-medic thickness and equal efficacy in terms of reducing the number of plaques inside the carotid artery.4) The combination therapy group outperformed the other two groups in terms of TCM symptoms curative effects、angina pectoris curative effect, electrocardiogram curative effect before and after treatment (P<0.05). The same curative as group of BAPR in terms of ameliorate TCM symptom scores.ConclusionThe blood-activating and phlegm-resolving formula combined with rosuvastatin calcium can effectively adjust TC, TG, LDL-C and HDL-C levels, reduce ox-LDL and MDA, and increase SOD for patients. The combination therapy is highly effective in adjusting intima-medic thickness and the number of plaques in the carotid artery. This therapy is more effective than treatment with Chinese or Western medicine only for As patients in terms of easing symptoms and improving efficacy. Specifically, the therapy helps stabilize the number of plaques, control the blood lipid level, prevent LDL from being oxidized into ox-LDL, and protect body cells against free radicals. In other words, the blood-activating and phlegm-resolving formula inhibits As through lipid adjustment, plaque stabilization and anti-oxidation. The combination of Chinese and Western medicine can subdue the occurrence and development of As through a number of procedures and targets to reduce the risk of cardiovascular diseases. |
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